Search

This review was designed to analyse whether the supplementary use of XP-Endo Finisher and XP-Endo Finisher R contributes to the removal of root canal filling materials. Databases were searched up to November 2020. Studies were critically assessed according to inclusion and exclusion criteria. Risk of bias evaluation was performed. Pooled standardised mean differences (SMD) and 95% confidence intervals (95% CI) were calculated. Ten studies involving 192 teeth were eligible for systematic review and meta-analysis could be performed with eight of these studies. Strong evidence showed that XP-Endo Finisher R file contributed significantly to filling material removal from root canals (SMD (95% CI): 0.41 (0.06-0.76)). Although the evidence was conflicting, XP-Endo Finisher R file was superior than other irrigant activation techniques (SMD (95% CI): 0.47 (0.02-0.93)). The supplementary use of XP-Endo Finisher and XP-Endo Finisher R is beneficial in further removal of root canal filling materials from root canal system.

Background.This study compared the effect of smear layer on the penetration depth and push-out bond strength of various root canal sealers. Methods.A total of 90 extracted human mandibular premolars were assigned into 2 groups: smear layer preserved and smear layer removed. Then the roots were further divided into 3 subgroups according to the sealer tested: AH 26, BioRoot RCS and MTA Plus. Obturation was performed with gutta-percha and the relevant sealer was mixed with 0.1% rhodamine B. Three 1-mm-thick slices were obtained from the mid-third area of each root. Two slices were selected for the push-out test and the remaining slice was used to calculate the dentinal tubule penetration depth and percentage. Results.The retention of MTA Plus and BioRoot RCS was higher than that of AH 26 when the smear layer was preserved (P

Separated root canal instruments may affect the quality of root canal obturation and hence the survival of endodontically treated teeth. Obturation techniques may influence filling-quality. The aim was to evaluate the obturation quality of teeth filled with different obturation techniques in the presence of apically separated instruments using micro-computed tomography (μ-CT). Notched ProTaper F2 rotary-files were separated in the apical third of 36-human mandibular incisors with single root/canal and mature apex. Samples were filled by an endodontist according to one of the following obturation techniques (n = 12): cold lateral-compaction (CLC), single-cone (SC) and thermoplastic injection (TI). Samples were scanned by the Skyscan 1,274® μ-CT device after 1-week at 37°C in 100% humidity. Images of the sections were evaluated with CTan software in terms of total-volume and volume percentage of the filling materials and voids between coronal end of the separated instrument and gutta-percha/sealer filled void-free sections. Data was analyzed using Kruskal-Wallis and Mann Whitney-U tests with a significance level of 5%. Kruskal-Wallis revealed differences among groups (p 0.05). Percentages of volumes of voids and filling materials were as follows for SC, CLC and TI, respectively: 8.88 ± 18.52% and 24.45 ± 38.40%, 46.92 ± 33.53% and 53.07 ± 33.53%, 40.54 ± 33.85% and 42.79 ± 34.45%. The obturation technique may have a significant impact on the volume of voids in the presence of a separated file. No obturation technique produced a void-free root canal filling.

The purpose of this study was to systematically review and critically analyze the published data of in vitro studies testing the effect of root canal sealers on the fracture resistance of endodontically treated teeth. A comprehensive literature search was performed by using the Medline, Scopus, Web of Science, Cochrane, and Open Grey databases. A hand search of the reference lists of identified articles was also performed. Two reviewers critically assessed the studies for eligibility against inclusion and exclusion criteria and performed data extraction. Evaluation of the risk of bias of the studies was performed. A total of 48 studies were assessed for eligibility. Of these, 20 met the inclusion criteria and were included in the systematic review. All studies had a medium or high risk of bias. Although the majority of the studies reported that the use of root canal sealers increased the fracture resistance of endodontically treated teeth, conflicting evidence was found for the reinforcing effect of resin, glass ionomer, and calcium silicate-based sealers while there was moderate evidence for zinc oxide eugenol-based sealers in favor of no reinforcing effect. On the basis of available evidence, the use of root canal sealer increases the fracture resistance of endodontically treated teeth. However, included studies presented considerable risk of bias. Regarding the comparisons among the sealers, no conclusions could be drawn for the superiority of one sealer type to another. A considerable heterogeneity was found in the methodologies of included studies. Therefore, this review strongly suggests the development of standardized methods to test the reinforcement effect of root canal filling materials in in vitro studies.

OBJECTIVE To investigate the effect of different irrigation protocols on microhardness (MH) and flexural strength (FS) values of young and aged crown dentin. BACKGROUND In addition to ageing, root canal irrigation might also affect the mechanical properties of coronal dentin walls. MATERIALS AND METHODS One hundred and twenty dentin bars (2 mm × 2 mm × 8 mm) were obtained from the crowns of extracted, non-caries, human molars of young and older patients (n = 60 bars; average patient ages: 16.7 and 65.4, respectively). Subgroups were formed as follows: 2.5%NaOCl(sodium hypochlorite)+5%EDTA(ethylenediaminetetraacetic acid), 2.5%NaOCl + 15%EDTA, 2.5%NaOCl, 5%EDTA, 15%EDTA and Saline. NaOCl and saline were used for 20 minutes and EDTA solutions for 1 minute. MH values of each sample were measured before and after the irrigation protocols. The same samples were also submitted for FS analysis. The data were statistically analysed. RESULTS Young samples had lower MH values at pre- and post-treatment compared to aged samples (P

Objective: The aim of this in vitro study was to evaluate the bond strength of a new calcium silicate cement, Neo MTA Plus (Avalon Biomed Inc. Bradenton, FL, U.S.A) by comparing ProRoot MTA and Biodentine. Material and Methods: Sixty dentin slices were instrumented to achieve a diameter of 1.3 mm. Group 1: white ProRoot MTA, group 2: Biodentine, group 3: Neo MTA Plus–G (powder mixed with gel), group 4: Neo MTA Plus–W (powder mixed with distilled water) were loaded into cavities. The push-out bond strength values were measured. Data were analyzed using Welch ANOVA with Bonferroni correction p = 0.05. Failure modes (adhesive, cohesive, and mixture) were analyzed. Results: The highest bond strength value was recorded in Neo MTA Plus mixed with gel (5.23 ± 1.78 MPa), whereas white ProRoot MTA (2.57 ± 0.66 MPa) had the lowest. Bond strength values of Neo MTA Plus mixed either with gel or with distilled water were statistically different from both white ProRoot MTA and Biodentine (2.61 ± 0.70 MPa) (p

In current dental practices, traditional restorative approaches may have relatively limited long-term survival and may be associated to diverse complications, such as allergy, pulpitis, or periodontal pathologies. To overcome these shortcomings, novel innovative strategies have been envisioned for tooth repair. During the two last decades, the extensive advances in our understanding of tooth development as well as stem cell research provide the foundation for exciting opportunities in dental tissue engineering. The replacement of lost teeth by engineered dental tissue appears as a fascinating goal. However, the feasibility remains an intriguing question. Is the challenge to create a new tooth acting as a substitute for lost tooth or to regenerate only part of this organ that is enamel, dentin, or dental pulp? Is it possible to exploit stem cells for transplantation purposes to promote matrix formation and mineralization in the framework of endodontic treatment? Finally, investigating the functional properties of pulpal stem cells is however mandatory to envision novel therapeutic dental strategies. In this review, we summarize the current knowledge of stem cells used for dental tissue engineering and discuss the ensuing challenges for regenerative dentistry.

The aim of this study was to evaluate the quality of the canal fillings performed by thermoplastic technique (Herofill) and cold lateral condensation (CLC) techniques in oval shaped canals following self-adjusting file (SAF) preparation using radiological, stereological, and microscopic evaluation methods. Twelve pairs of oval-shaped root canals were prepared with SAF and filled using CLC (n = 12) or the Herofill system (n = 12). The quality of the root canal filling was evaluated by (i) scoring bidirectional storage phosphor plate images, (ii) stereological (volumetric) analysis of cone beam computerized tomography (CBCT) images, and (iii) microscopic analysis of the cross-sectioned area of the canal and gutta-percha via image analysis software. Chi-square test, t-test, and Mann-Whitney U-tests were used respectively (p 0.05). Herofill was not superior to cold lateral compaction. Stereology can be used to obtain unbiased information about the volume of root canal fillings. Both filling techniques failed to achieve the desirable goal of 0% empty volume in all of the cases and all evaluation systems confirmed this result. SCANNING 38:427-433, 2016. © 2015 Wiley Periodicals, Inc.

Background: The effect of solvent and sealer type (BioRoot RCS [BRRCS], mineral trioxide aggregate [MTA] Fillapex, and AH26) on the root canal residues was evaluated by confocal laser scanning microscopy (CLSM). Materials and Methods: Distal root canals of 60 mandibular molars prepared up to ProTaper-F4 were filled using one of the sealers labeled with 0.1% rhodamine-B (n = 20 per sealer). Samples were divided into two according to reprocessing methods as follows: ProTaper Universal Reprocessing System (PTUR) or solvent plus PTUR. Samples were sectioned at 2–5 and 8 mm from the apex and the samples were observed under CLSM. Penetration depth, percent penetration depth, and percent penetration into canal walls were evaluated. Statistical analysis was performed using the repeated measures of the two-way ANOVA and Bonferroni post hoc test at P = 0.05. Results: The highest penetration depth was measured in BRRCS in all root canal thirds with or without chloroform addition. Percentage of penetration depth values of MTA Fillapex and BRRCS was statistically similar and higher than AH26 in all sections, except the apical section re-treated with the addition of chloroform. Conclusion: None of the sealers were completely removed. The type of sealant and the use of chloroform changed the amount of sealant remaining in the root canal system.

Introduction: The purpose of this study was to evaluate the effect of calcium hydroxide (Ca[OH]2) dressing on the dentinal tubule penetration of epoxy resin–based sealer (AH 26; Dentsply Maillefer, Ballaigues, Switzerland) and tricalcium silicate–based sealer (BioRoot RCS; Septodont, Saint Maurdes Fosses, France). Methods: Fifty-two single-rooted mandibular premolars were used. Four samples were assigned as the positive control. Twenty-four samples received Ca(OH)2 labeled with rhodamine B, whereas the rest did not. Ca(OH)2 was removed with passive ultrasonic activation and copious irrigation 2 weeks later. Samples were further subdivided into 2 groups, and root canal fillings were performed with a single ProTaper F4 gutta-percha cone (Dentsply Maillefer) combined with 1 of the tested sealers labeled with fluorescein green. After 2 weeks, samples were transversely sectioned at the apical, middle, and coronal levels. The penetration depth and percentage were evaluated via imaging software. Statistical analysis was performed using Kruskal-Wallis, Siegel Castellan post hoc, and Mann-Whitney U tests at P =.05. Results: The mean dentinal tubule penetration depth and percentage values were lowest in the apical third for both sealers. BioRoot RCS showed higher penetrability in all thirds compared with AH 26 (P .05). Conclusions: Passive ultrasonic activation and copious irrigation were insufficient in removing Ca(OH)2 from root canals. BioRoot RCS presented higher dentinal tubule penetration than AH 26 even in the presence of Ca(OH)2 residues. Ca(OH)2 remnants decreased both dentinal tubule penetration depth and the percentage of the tested sealers; however, a more drastic effect was observed for AH 26. © 2018 American Association of Endodontists

Objectives This study aimed to introduce the use of laser-induced breakdown spectroscopy (LIBS) for evaluation of the mineral content of root canal dentin, and to assess whether a correlation exists between LIBS and scanning electron microscopy/energy dispersive spectroscopy (SEM/EDS) methods by comparing the effects of irrigation solutions on the mineral content change of root canal dentin. Materials and Methods Forty teeth with a single root canal were decoronated and longitudinally sectioned to expose the canals. The root halves were divided into 4 groups (n = 10) according to the solution applied: group NaOCl, 5.25% sodium hypochlorite (NaOCl) for 1 hour; group EDTA, 17% ethylenediaminetetraacetic acid (EDTA) for 2 minutes; group NaOCl+EDTA, 5.25% NaOCl for 1 hour and 17% EDTA for 2 minutes; a control group. Each root half belonging to the same root was evaluated for mineral content with either LIBS or SEM/EDS methods. The data were analyzed statistically. Results In groups NaOCl and NaOCl+EDTA, the calcium (Ca)/phosphorus (P) ratio decreased while the sodium (Na) level increased compared with the other groups (p < 0.05). The magnesium (Mg) level changes were not significant among the groups. A significant positive correlation was found between the results of LIBS and SEM/EDS analyses (r = 0.84, p < 0.001). Conclusions Treatment with NaOCl for 1 hour altered the mineral content of dentin, while EDTA application for 2 minutes had no effect on the elemental composition. The LIBS method proved to be reliable while providing data for the elemental composition of root canal dentin.

Objectives The aim was to evaluate dentinal crack formation after root canal preparation with ProTaper Next system (PTN) with and without a glide path. Materials and Methods Forty-five mesial roots of mandibular first molars were selected. Fifteen teeth were left unprepared and served as controls. The experimental groups consist of mesiobuccal and mesiolingual root canals of remaining 30 teeth, which were divided into 2 groups (n = 15): Group PG/PTN, glide path was created with ProGlider (PG) and then canals were shaped with PTN system; Group PTN, glide path was not prepared and canals were shaped with PTN system only. All roots were sectioned perpendicular to the long axis at 1, 2, 3, 4, 6, and 8 mm from the apex, and the sections were observed under a stereomicroscope. The presence/absence of cracks was recorded. Data were analyzed with chi-square tests with Yates correction. Results There were no significant differences in crack formation between the PTN with and without glide path preparation. The incidence of cracks observed in PG/PTN and PTN groups was 17.8% and 28.9%, respectively. Conclusions The creation of a glide path with ProGlider before ProTaper Next rotary system did not influence dentinal crack formation in root canals.

Objectives This study compared the ability of several techniques to remove calcium hydroxide (CH) from the root canal and determined the influence of CH residues on the accuracy of the electronic apex locator. Materials and Methods Root canals of 90 human maxillary lateral incisors with confirmed true working length (TWL) were prepared and filled with CH. The teeth were randomly assigned to one of the experimental groups according to the CH removal technique (n = 14): 0.9% saline; 0.9% saline + master apical file (MAF); 17% ethylenediamine tetraacetic acid (EDTA); 17% EDTA + MAF; 5.25% sodium hypochlorite (NaOCl); 5.25% NaOCl + MAF. Six teeth were used as negative control. After CH removal, the electronic working length was measured using Root-ZX (Morita Corp.) and compared with TWL to evaluate Root-ZX accuracy. All specimens were sectioned longitudinally, and the area of remaining CH (CH) and total canal area were measured using imaging software. Results The EDTA + MAF and NaOCl + MAF groups showed better CH removal than other groups (p < 0.05). Root-ZX reliability to prevent overestimated working length to be > 85% within a tolerance of ± 1.0 mm (p < 0.05). There was strong negative correlation between amount of CH residues and EAL accuracy (r = -0.800 for ± 0.5 mm; r = -0.940 for ± 1.0 mm). Conclusions The mechanical instrumentation improves the CH removal of irrigation solutions although none of the techniques removed the dressing completely. Residues of CH medication in root canals affected the accuracy of Root-ZX adversely.

Background: This study aimed to compare glide path preparation of different pathfinding systems and their effects on the apical transportation of ProTaper Next (Dentsply Maillefer, Ballaigues, Switzerland) in mesial root canals of extracted human mandibular molars, using digital subtraction radiography. Materials and Methods: The mesial canals of 40 mandibular first molars (with curvature angles between 25° and 35°) were selected for this study. The specimens were divided randomly into 4 groups with 10 canals each. Glide paths were created in group 1 with #10, #15 and #20 K-type (Dentsply Maillefer, Ballaigues, Switzerland) stainless steel manual files; in group 2 with Path-File (Dentsply Maillefer) #1, #2, and #3 and in group 3 with #16 ProGlider (Dentsply Maillefer) rotary instruments; in group 4 no glide paths were created. All canals were instrumented up to ProTaper Next X2 to the working length. A double digital radiograph technique was used, pre and post-instrumentation, to assess whether apical transportation and/or aberration in root canal morphology occurred. Instrument failures were also recorded. The data were analyzed statistically using ANOVA and Tukey tests ( p 0.05). Two ProTaper Next instruments failed in-group 4. Conclusions: Within the parameters of this study, there was no difference between the performance of path-finding files and ProTaper Next system maintained root canal curvature well and was safe to use either with path-finding files or alone.

Objectives To determine the effect of size and insertion depth of irrigation needle on the amount of apical extruded debris and the amount of penetration depth of sealer using a confocal laser scanning microscope (CLSM). Materials and Methods Twenty maxillary premolars were assigned to 2 groups (n = 10), according to the size of needle tip, 28 G or 30 G. Buccal roots of samples were irrigated with respective needle type inserted 1 mm short of the working length (WL), while palatal roots were irrigated with respective needle type inserted 3 mm short of the WL. Prepared teeth were removed from the pre-weighed Eppendorf tubes. Canals were filled with F3 gutta-percha cone and rhodamine B dye-labeled AH 26 sealer. Teeth were transversally sectioned at 1 and 3 mm levels from the apex and observed under a CLSM. Eppendorf tubes were incubated to evaporate the irrigant and were weighed again. The difference between pre- and post-weights was calculated, and statistical evaluation was performed. Results Inserting needles closer to the apex and using needles with wider diameters were associated with significantly more debris extrusion (p < 0.05). The position of needles and level of sections had statistically significant effects on sealer penetration depth (p < 0.05 for both). Conclusions Following preparation, inserting narrower needles compatible with the final apical diameter of the prepared root canal at 3 mm short of WL during final irrigation might prevent debris extrusion and improve sealer penetration in the apical third.

The aims were to evaluate the effects of different additives on the adaptation of mineral trioxide aggregate (MTA) plugs before and after different backfilling techniques and analyze the interference of filling procedures on the fracture resistance of simulated immature teeth. The apical parts of 60 teeth were filled with MTA mixed with distilled water (DW), propylene glycol (PG) or calcium chloride (CaCl2) and backfilled with cold lateral condensation (CLC) or warm vertical compaction (WVC). The specimens were subjected to adaptation analysis and fracture testing. CaCl2 addition resulted in poor marginal adaptation, while PG addition significantly decreased the fracture values (p

Introduction The aim of this in vitro study was to evaluate the amount of apically extruded bacteria associated with several root canal preparation systems. Methods Forty-four extracted human mandibular premolar root canals were contaminated with an Enterococcus faecalis suspension. After incubation at 37°C for 24 hours, the root canals were instrumented using the Twisted File (SybronEndo, Orange, CA), OneShape (Micro Mega, Besançon, France), and ProTaper Next (Dentsply Maillefer, Ballaigues, Switzerland). During instrumentation, apically extruded bacteria were collected into vials containing 0.9% NaCl. The microbiological samples were taken from the vials and incubated in brain-heart agar medium for 24 hours. The numbers of colony-forming units were determined. The data obtained were analyzed using Welch analysis of variance followed by post hoc Games-Howell tests. Results ProTaper Next extruded the highest amount of bacteria, whereas OneShape extruded the least compared with all the other instruments (P =.004). There was a significant difference between OneShape and ProTaper Next in the number of colony-forming units (P =.007) but not between OneShape and Twisted File (P >.05). Conclusions All instrumentation systems extruded bacteria beyond the foramen. The OneShape system extruded less bacteria compared with the Twisted File and ProTaper Next systems. © 2015 American Association of Endodontists.

Objectives This study evaluated the effects of intraradicular moisture on the pushout bond strength of a fibre post luted with several self-adhesive resin cements. Materials and Methods Endodontically treated root canals were treated with one of three luting cements: (1) RelyX U100, (2) Clearfil SA, and (3) G-Cem. Roots were then divided into four subgroups according to the moisture condition tested: (I) dry: excess water removed with paper points followed by dehydration with 95% ethanol, (II) normal moisture: canals blot-dried with paper points until appearing dry, (III) moist: canals dried by low vacuum using a Luer adapter, and (IV) wet: canals remained totally flooded. Two 1-mm-thick slices were obtained from each root sample and bond strength was measured using a push-out test setup. The data were analysed using a two-way analysis of variance and the Bonferroni post hoc test with p = 0.05. Results Statistical analysis demonstrated that moisture levels had a significant effect on the bond strength of luting cements (p < 0.05), with the exception of G-Cem. RelyX U100 displayed the highest bond strength under moist conditions (III). Clearfil SA had the highest bond strength under normal moisture conditions (II). Statistical ranking of bond strength values was as follows: RelyX U100 > Clearfil SA > G-Cem. Conclusions The degree of residual moisture significantly affected the adhesion of luting cements to radicular dentine.

Aim: The aim of this study was to evaluate the influence of different endodontic materials and final irrigation regimens on vertical root fracture (VRF) resistance.Materials and Methods: Eighty human teeth were prepared then assigned into two groups (n = 40) according to the final irrigations. G1: 5 mL, 5.25% sodium hypochlorite (NaOCl), G2: 5 mL, 2% chlorhexidine gluconate (CHX). Each group was assigned into four subgroups according to the obturation system used (n = 10): A: iRoot SP/single gutta‑percha cone (SGP), B: Only iRoot SP, C: Mineral trioxide aggregate (MTA)‑Fillapex/SGP, D: AH26/SGP. The specimens were embedded in acrylic molds and subjected to compressive loading at a rate of 1 mm min until VRF occurred. Data were analyzed via three‑way ANOVA tests.Results: The statistically significant difference was found among groups (P < 0.05). The G1A and G1B and G1D revealed significantly higher‑VRF values than G1C (P = 0.023). The roots filled with MTA‑Fillapex revealed lower‑VRF values than the other subgroups (P < 0.05). Groups irrigated with NaOCl had significantly lower‑VRF values than the groups irrigated with CHX (P < 0.05).Conclusion: Final irrigation regimens could alter VRF resistance of root canals filled with different obturation technique and root canal sealers.Key words: Chlorhexidine gluconate, root canal sealers, sodium hypochlorite, vertical root fracture

Objective: To evaluate the influence of manual and mechanical mixing techniques as well as the effects of moisture on the push-out bond strength of ProRoot MTA (Dentsply Tulsa Dental, Tulsa, OK, USA) and Biodentine (Septodont, Saint Maur des Fosses, France) to radicular dentin.Material and methods: Two hundred and forty dentin discs were assigned into three groups with respect to the moisture condition tested: (1) dry, (2) paper points, (3) wet. The discs were further divided into four subgroups according to the calcium silicate cements (CSCs) and mixing techniques used: (1) ProRoot MTA mixed manually, (2) ProRoot MTA mixed mechanically, (3) Biodentine mixed manually, and (4) Biodentine mixed mechanically. Bond strengths of the cements to root canal dentin were measured using a push-out test setup. The data were statistically analyzed using three-way ANOVA and Bonferroni post hoc test p = 0.05.Results: The data indicated that the push-out bond strength values were significantly affected by CSCs, mixing techniques, and moisture conditions (p < 0.001). Dry conditions caused a significant decrease in bond strength values for both CSCs (p < 0.001). The mean bond strength of Biodentine was significantly higher than that of ProRoot MTA, regardless of the mixing techniques and moisture conditions (p < 0.001). Mechanical mixing favored bond strength values statistically compared to manual mixing (p

Objective: To evaluate the amount of apically extruded debris during retreatment (with or without solvent) of root canals filled by two obturation techniques.Materials and Methods: Forty‑eight root canals were prepared using ProTaper Universal F3 and filled with Gutta‑percha and AH 26 sealer using single cone or lateral condensation techniques. The root canal fillings were removed using ProTaper Universal Retreatment system with or without solvent, and the canals were further prepared with ProTaper F4. The operating time was measured. The debris extruded was collected into preweighed Eppendorf tubes. The dry weight of the extruded debris was calculated by subtracting the weight of the empty tube from that of the tube containing debris. Statistical analysis was performed with two‑way analysis of variance test, with Bonferroni correction at a 95% confidence level.Results: There was no statistically significant difference in the amount of extruded debris between the two obturation techniques (P = 0.332). The mean amount of debris was higher in the nonsolvent groups than the solvent groups, particularly with the single cone technique (P = 0.013). There was a significant difference between groups with regard to the retreatment time (P < 0.001). Gutta‑percha removal took less time in the single cone group than in the lateral condensation group (P < 0.001). Gutta‑percha removal in the nonsolvent groups took significantly less time than that in the solvent groups (P < 0.001).Conclusions: The amounts of apically extruded debris were similar in both obturation techniques. A greater amount of apically extruded debris was observed in the nonsolvent groups than the solvent groups.Keywords: Apical Extrusion, Retreatment, Solvent

The purpose of this study was to compare the effect of different final irrigation solutions on fracture resistance values (FRVs) of endodontically treated teeth.Eighty extracted decoronated human incisors were used. Ten randomly selected roots were used as the negative control group. The remaining roots were prepared by the ProTaper system (Dentsply Maillefer, Ballaigues, Switzerland) up to F2. Ten prepared roots were selected as the positive control. The other prepared roots were divided into 6 (n = 10) groups according to the final irrigation solution used: 5 mL saline, 17% EDTA, EDTA with a surfactant (REDTA), chlorhexidine, QMix (Dentsply Tulsa Dental Specialties, Tulsa, OK), and BioPure MTAD (Dentsply Tulsa Dental Specialties). In all groups, the final irrigation was performed for 1 minute except for the BioPure MTAD group; in this group, it was applied for 5 minutes according to the manufacturer's instructions. The specimens were filled with a single gutta-percha cone and AH 26 sealer (Dentsply, De Trey, Konstanz, Germany). After being stored under 37 °C and 100% humidity for a week, the specimens were loaded in a vertical direction at 1 mm/min speed until they were vertically fractured. The results were analyzed by the Kruskal-Wallis and Siegel Castellan tests.The negative control group showed the highest FRV. There were statistically significant differences between the negative and positive control groups (P.05). Specimens irrigated with REDTA and QMix showed a higher FRV compared with the positive control group (P.05). Specimens exposed to chlorhexidine and BioPure MTAD showed a lower FRV compared with the negative control group (P.05).Root canal preparation weakens the tooth. The final irrigation regimen has an impact on the FRV. A short time exposure to irrigation solutions (REDTA and QMix) that include surfactants probably contributed to the higher FRV, instead of a long time exposure as done with BioPure MTAD.

Introduction The aim of this study was to estimate the remaining amount of residual filling materials in root canals after retreatment using ProTaper Universal Retreatment (PTUR) files (Dentsply Maillefer, Ballaigues, Switzerland) alone or with the additional use of the Self-Adjusting File (SAF; ReDent-Nova, Ra'anana, Israel), Reciproc (VDW, Munich, Germany), or Hedstrom-files (H-file; VDW, Antaeos, Munich, Germany) with volumetric estimation using the stereologic method via cone-beam computed tomographic images. Methods Forty-eight mandibular premolars with single canals were used. The canals were instrumented with ProTaper rotary instruments up to F4 and filled with gutta-percha and AH26 sealer (Dentsply De Trey, Johnson City, TN). All the samples were placed into the silicone models. Samples were scanned with cone-beam computed tomographic imaging and assigned into 4 groups ( n = 12) according to retreatment files: the PTUR system group, the PTUR system plus SAF group, the PTUR system plus Reciproc group, and the PTUR system plus H-file group. The specimens were rescanned after retreatment procedures, and the volume estimations of the remaining filling materials were performed using the stereologic method. Data were analyzed using Kruskal-Wallis and Dunn tests. Results There was no significant difference among the groups regarding mean percentage volumes of the filling materials before retreatment procedures ( P > .05). None of the retreatment procedures provided complete removal of the filling materials. The additional use of the SAF did not significantly improve the removal of filling materials when compared with the PTUR system alone ( P > .05). However, the additional use of Reciproc or hand H-files significantly improved the removal of filling materials when compared with the PTUR system alone ( P Conclusions The additional use of files with different motion kinetics improved the removal of root canal fillings; however, none of the systems completely removed the root canal filling material from the root canals.

AimOne Shape Apical 1 (OSA 1) is a new file for preparing the apical aspect of the root canal after One Shape (OS, Micro Mega, Besançon, France). This study compared apical transportation and centering ratios in curved root canals, which were instrumented with ProTaper Next (PTN, Dentsply Tulsa Dental Specialties, Tulsa, OK) up to size X3 and with OS up to OSA 1.Materials and methodsForty-eight mesial canals of mandibular molars were assigned into two groups (n = 24) with respect to canal length and curvature. Root canals were accessed conventionally and preperation was completed with PTN files up to X3 or with OS up to OSA 1 according to the manufacturer's protocols. Apical transportation was assessed pre- and postinstrumentation using cone-beam computed tomographic (CBCT) scans of 1, 2, 3, 4, and 5 mm sections. A Friedman test was performed to assess the significance between file systems.ResultsNo significant difference was found between the file systems regarding apical transportation and centering ratio values (p > 0.05). Transportation in the mesial direction was greater than the distal transportation for both file systems.ConclusionConsidering apical transportation and centering ratio in curved canals, two systems provided similar results.Clinical significancePreparation up to One Shape Apical 1 or ProTaper Next X3 was shown similar results regarding apical transportation and centering ratio. Both systems were safe to use in curved molar root canals.How to cite this articleUzunoglu E, Turker SA. Comparison of Canal Transportation, Centering Ratio by Cone-beam Computed Tomography after Preparation with Different File Systems. J Contemp Dent Pract 2015;16(5):360-365.

The importance of inflammation has been underestimated in pulpal healing, and in the past, it has been considered only as an undesirable effect. Associated with moderate inflammation, necrosis includes pyroptosis, apoptosis, and nemosis. There are now evidences that inflammation is a prerequisite for pulp healing, with series of events ahead of regeneration. Immunocompetent cells are recruited in the apical part. They slide along the root and migrate toward the crown. Due to the high alkalinity of the capping agent, pulp cells display mild inflammation, proliferate, and increase in number and size and initiate mineralization. Pulp fibroblasts become odontoblast-like cells producing type I collagen, alkaline phosphatase, and SPARC/osteonectin. Molecules of the SIBLING family, matrix metalloproteinases, and vascular and nerve mediators are also implicated in the formation of a reparative dentinal bridge, osteo/orthodentin closing the pulp exposure. Beneath a calciotraumatic line, a thin layer identified as reactionary dentin underlines the periphery of the pulp chamber. Inflammatory and/or noninflammatory processes contribute to produce a reparative dentinal bridge closing the pulp exposure, with minute canaliculi and large tunnel defects. Depending on the form and severity of the inflammatory and noninflammatory processes, and according to the capping agent, pulp reactions are induced specifically.

Background: Bond strength of root canal sealers is mainly influenced by the surface tension of the root canal wall. Heat, or the use of a surfactant might reduce surface tension and it is known that surface tension of an EDTA solution significantly affected from temperature rise. QMix is a novel endodontic irrigant for smear layer removal containing EDTA, chlorhexidine and a detergent. There is no data regarding the influence of the temperature of the EDTA and QMix on the push-out bond strength of root canal sealers. Aim: To evaluate effect of temperatures of QMix and EDTA on the bond-strength of AH Plus. Materials and Methods: Sixty premolars were prepared with ProTaper F4. During preparation 3% NaOCl was performed. Specimens were divided into 4 groups as follows: 5-mL 17% EDTA at 22°C and 37°C; 5-mL QMix at 22°C and 37°C. Three specimens from each group were prepared for observation using SEM. Remaining roots were obturated and prepared for a push-out test. Data was analysed using Anova and Bonferroni tests (p

The aim of this study was to compare the apically extruded debris associated with ProTaper Next and OneShape Apical files using two different irrigation needles, open-ended and closed-ended (Max-I-Probe). Forty-eight mandibular premolars were assigned to four groups (n=12) as follows: Group PTN-SN: Root canal was prepared with ProTaper Next (PTN) and irrigated with open-ended standard needle; Group PTN-MP: Root canal was prepared with PTN and irrigated with Max-I-Probe; Group OSA-SN: Root canal was prepared with OneShape Apical (OSA) and irrigated with open-ended needle; Group OSA-MP: Root canal was prepared with OSA and irrigated with Max-I-Probe. Debris extruded during instrumentation was collected into pre-weighed Eppendorf tubes. After storage in an incubator at 70 °C for 5 days, the Eppendorf tubes were weighed to obtain the final weight with extruded debris. The difference between pre-and post-debris weights was calculated and statistical analysis was performed using Kruskal-Wallis and Mann-Whitney U tests (p0.05). OneShape Apical and ProTaper Next resulted in extrusion of debris beyond the apical foramen, regardless of needle tip. O objetivo do presente estudo foi comparar a extrusão apical de restos de preparação de canais, associada às brocas ProTaper Next e OneShape Apical usando duas agulhas de irrigação, de ponta aberta e ponta fechada (Max-I-Probe). Quarenta e oito premolares inferiores foram divididos em quatro grupos (n=12): Grupo PTN-SN: o canal radicular foi preparado com ProTaper Next (PTN) e irrigado com agulha convencional de ponta aberta; Grupo PTN-MP: o canal radicular foi preparado com PTN e irrigado com Max-I-Probe; Grupo OSA-SN: o canal radicular foi preparado com OneShape Apical (OSA) e irrigado com agulha de ponta aberta; Grupo OSA-MP: o canal radicular foi preparado com OSA e irrigado com Max-I-Probe. Os restos extrudados apicalmente foram coletados em tubos Eppendorf previamente pesados. Após armazenagem por cinco dias a 70 °C, os tubos Eppendorf foram pesados para obter o peso final com os resíduos. A diferença entre as pesagens antes e depois foi calculada e análise estatística foi feita usando os testes de Kruskal-Wallis e Mann-Whitney U (p0,05). As brocas ProTaper Next e OneShape Apical promoveram extrusão além do forame apical, independente do tipo de agulha utilizada.

The objective of this study was to evaluate the effect of ethylenediaminetetraacetic acid (EDTA) on root fracture with respect to various concentrations at different time exposures.A total of 48 mandibular incisors were selected. Eight nonprepared roots were selected as a negative control. The remaining 40 specimens were instrumented with rotary files and randomly assigned to one of the following groups for final irrigation: (1) 10 mL distilled water for 10 minutes (positive control); (2) 10 mL of 17% EDTA for 1 minute + 10 mL of 1% NaOCl for 1 minute; (3) 10 mL of 5% EDTA for 1 minute + 10 mL of 1% NaOCl for 1 minute; (4) 10 mL of 17% EDTA for 10 minutes + 10 mL of 1% NaOCl for 1 minute; (5) 10 mL of 5% EDTA for 10 minutes + 10 mL of 1% NaOCl for 1 minute. Thereafter, the root canals were filled by using AH26 root canal sealer with a single-cone technique. The specimens were loaded vertically at 1 mm/min crosshead speed until vertical root fracture occurred. Results were evaluated statistically with 1-way analysis of variance and Student's t test.Statistically significant differences were detected among the groups (P.05). The highest mean fracture resistance was obtained from the group treated with 5% EDTA for 10 minutes. This is about 2 times more than the weakest mean fracture resistance, which was obtained from the 17% EDTA-10 minute group.The fracture resistances of endodontically treated roots were found to be differently affected by the various concentrations of EDTA at different time exposures.